AN EVALUATION OF THE ROLE OF INTERNAL CUES IN THE PATHOGENESIS OF PARKINSONIAN HYPOKINESIA
AN EVALUATION OF THE ROLE OF INTERNAL CUES IN THE PATHOGENESIS OF PARKINSONIAN HYPOKINESIA
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DOI：
10.1093/brain/116.6.1575
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发表时间：
1993-12-01
期刊：
影响因子：
14.5
通讯作者：
BRADSHAW, JA
中科院分区：
文献类型：
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作者：
GEORGIOU, N;IANSEK, R;BRADSHAW, JA
我们的动物研究表明，基底神经节提供了一种内部非特异性线索来触发运动，并暗示帕金森病涉及这种线索机制的缺陷。事实上，帕金森病患者通常依赖外部视觉线索。为了评估这种非特异性提示机制对运动的影响，我们检查了患者对各种听觉提示的利用。十名患有帕金森病的患者及其匹配的对照者，在一系列双向选择点处按顺序沿着一条路径按下按钮，当后者在整个长度上保持照明时，以及当它必须仅凭记忆遵循时。在其他实验条件下，还根据先前的响应在其开始（中等水平的预先信息）或完成（低水平的预先信息）时提供听觉提示，或者作为一系列有规律节奏（非偶然）的听觉提示（来自节拍器）。除了错误数据之外，我们还记录了停机时间（DT，启动每个下一个响应的时间）和移动时间（MT），执行每个下一个响应的时间）。然而，DT 和 MT 测量结果表明，帕金森病患者由于缺乏外部线索而处于极大的不利地位。虽然偶然的听觉提示有一定帮助，但通过提供非偶然的听觉信息，帕金森病患者的表现得到了显着改善。此外，与对照组不同，帕金森病患者受到个体次运动长度的极大影响，尤其是在没有外部提示的情况下。当要遵循的路径保持照亮时，子运动长度几乎没有影响。我们得出的结论是，对于充分学习的、可预测的序列，基底神经节提供了一种非特定的内部线索，对于在运动序列中的一个运动和下一个运动之间切换以及为序列中的每个子运动进行准备活动是必要的。
Our animal studies suggest that the basal ganglia provide an internal non-specific cue to trigger movement and imply that Parkinson's disease involves a deficiency in this cueing mechanism. Indeed parkinsonian patients typically rely upon external visual cues. To assess the effects of such non-specific cueing mechanisms on movement, we examined patients' utilization of a variety of auditory cues. Ten patients suffering from Parkinson's disease, and their matched controls, pressed buttons at a series of two-way choice points sequentially down a pathway, both when the latter remained illuminated throughout its length, and when it had to be followed from memory alone. In other experimental conditions, auditory cues were also provided, either contingent upon the previous response, at its initiation (a medium level of advance information) or at its completion (a low level of advance information), or as a series of regularly paced (non-contingent) auditory cues (from a metronome). In addition to error data, we recorded down time (DT, time to initiate each next response) and movement time (MT), time to execute each next response). However, both DT and MT measurements showed that parkinsonian patients were enormously disadvantaged by the absence of external cues. While contingent auditory cues were of some help, the performance of patients with Parkinson's disease was dramatically improved by the provision of non-contingent auditory information. Moreover, parkinsonian patients, unlike controls, were greatly affected by the length of individual sub-movements, especially in the absence of external cues. When the pathway to be followed remained illuminated, sub-movement length had little effect. We conclude that for well-learnt, predictable sequences the basal ganglia provide a non-specific internal cue that is necessary for switching between one movement and the next in a movement sequence, and also for development of preparatory activity for each sub-movement in the sequence.